Press Release

Fraud scheme on medicines insurance

At least nine people, four of whom are officials of the Regional Directorate of Security Fund Mandatory Health Tirana and five leading pharmacy in the capital, were identified at that stage of the investigation as suspects for the creation of a huge fraud scheme reimbursement of medicines, that based on a preliminary assessment, the state has caused damage around 56 million ALL.

While the investigation is continuing also for other persons involved, Tirana Prosecution Office, Task Force Unit issued detention orders for nine nationals, which are executed by the State Police forces.
Tirana Prosecution office has started investigating the case for offenses of “Fraud with subsidies,” “Forgery of documents health”, “Laundering proceeds of crime” and “Abuse of office” in dated 22.05.2015, based on information coming from the Security Fund Mandatory Health (FSDKSH).

From the investigations so far are suspected some employees of Healthcare Fund Tirana who, in violation of the law, have given some pharmacies the right to benefit from reimbursement of medicines.
Some investigative actions showed that during the period September 2014 – March 2015, these pharmacies have illegally benefited a total reimbursement from the state to the value of 55,941,901 ALL. The investigation of Tirana Prosecution Office shows that drugs, whose prices are repaid, have been mainly in the treatment of tumor diseases.

Investigative actions are performed on medical prescriptions, which have served to pharmacies to give customers reimbursable medications. By these actions results that doctors, whose recipes have been subject to verification, are forged.

Following the investigation, it appears that the employees of the Regional Directorate (FSDKSH) Tirana, with their acts and omissions, willfully, in violation of the law and the fulfillment of duty, have allowed pharmacies to benefit unfairly. These employees have enabled the contracts with these pharmacies, as the pharmacies did not meet the criteria required by the law and bylaws in force.
In these circumstances, the Prosecution Office has forbid the citizens:

1.  P. Xhuvani, director at the Regional Directorate of the Fund  Tirana (court decided “imprisonment custody”)
2.  E. Mara, lawyer at the Regional Directorate of the Fund (court decided “house arrest”)
3.  K. Mahmutaj, Officer at the Regional Directorate of the Fund (court has decided “house arrest”)
4.  F. Lamçe, officer at the Regional Directorate of the Fund (the court decided “house arrest”)
5.  H. Roci, Administrator of Pharmacy, Lunder (court decided “imprisonment custody”)
6.  M. Tufi, Technical Leader of pharmacy Lunder (court decided "obligatory presence")
7.  N. Thanasi, Technical Director of Pharmacy “Nutrimed” (court decided "obligatory presence")
8.  A. Spahiu, Technical Director of Pharmacy Berzhite (court decided "obligatory presence")
9.  A. Manaj, Technical Leader of pharmacy “Adelina” (court decided "obligatory presence")

Meanwhile, the Tirana Prosecution Office is continuing investigations to identify possible collaborators in this fraud scheme of the reimbursement of medical drugs.